The Impact of COVID-19 on Dental Nursing – the Forgotten Profession ©FG Trade/Istock/Getty Images Plus Trade/Istock/Getty ©FG
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FEATURE The impact of COVID-19 on dental nursing – The forgotten profession ©FG Trade/iStock/Getty Images Plus Trade/iStock/Getty ©FG M. Dingle1 and C. Balmer2 conducted a study of 1,006 dental nurses. Thirty-two percent reported difficulty paying their annual retention fee to the GDC and 65% have considered leaving dentistry. Abstract further afeld. In the UK, the dental profession has faced numerous Introduction Te experiences of the dental nursing profession challenges since the four Chief Dental Ofcers advised the cessation though the COVID-19 pandemic is not well publicised. Aims To of all routine face-to-face dentistry on 25 March 2020.1 Te negative highlight the impact that COVID-19 has had on our dental nursing efect COVID-19 has had on patients’ ability to access urgent care has colleagues. Design A 24-point anonymous online survey created been well documented at national level, with emotive reports such using Microsof Forms, collecting both quantitative and qualitative as a patient extracting his own molar without local anaesthetic being data. Setting A link to the survey was shared on fve popular published on the national BBC news website.2 Te impact COVID- national UK dental nursing Facebook groups, the majority of 19 has had on dentists themselves has also been well publicised with which require a name and associated GDC number to become a the help of the British Dental Association (BDA), with numerous member. Materials and method A link to the survey was shared stories being published in the national press highlighting the fnancial on 21 September 2020 and was open for four weeks. Results: One hardship many dentists are having to endure.3 thousand and six dental nurses completed the questionnaire by Within current publications there is an obvious defcit concerning 22 October 2020. Eight hundred and eighty-eight respondents the experiences of key members of the dental team, our dental work in a dental practice, 65% NHS and 35% private. Seven nurse colleagues. Professor Phil Taylor, Dean of the Royal College percent of respondents have been redeployed whilst 48% of Surgeons of Edinburgh (RCSEd)’s Faculty of Dental Surgery has report being furloughed. Forty-nine percent report COVID- raised concerns about a potential wave of dental nurse jobs being put 19 has had a negative efect on their personal fnances and at risk due to the fnancial uncertainty the pandemic brings. Professor 32% report fnancial difculty paying their GDC registration. Taylor goes on to state that ‘dental nurses play a vital role in the Sixty-fve percent have considered leaving dentistry altogether. dental profession and are an essential part of the team. It is of utmost Discussion Nearly two-thirds of the respondents have importance that they are supported during this period… they need considered leaving the profession, commonly stating stress, better support from the UK Government as well as the NHS as they pay and the General Dental Council (GDC) annual retention adjust to new regulations, PPE and AGP procedures’.4 fee (ARF) as determining factors. Conclusion Dental nurses Triggered by the COVID-19 pandemic, the British Association of are indispensable members of the dental team and it is Dental Nurses (BADN) are currently campaigning for recognition of worrying to see such high levels of dissatisfaction within dental nurses’ contribution to dentistry and have produced a template their profession. letter for members to send to their local MPs.5 BADN President Jacqui Elsden explains the key issue this letter seeks to address: recognition of Introduction NHS employment status - with the associated benefts: access to NHS It is clear that the COVID-19 pandemic has had a huge pension scheme, key worker status and salary banding - refecting the impact on dentistry in both the United Kingdom and fnancial outgoings such as registration fees, indemnity cover, training 1Matthew Dingle BDS, MFDS RCSEd, PGCME, Clinical Lecturer in Oral Surgery, Liverpool University Dental Hospital; 2Miss Colette Balmer BSc (Hons), BChD, FDSRCS (Edin), FDSRCS (Eng),PCTLCP, MA Clin Ed, FHEA, Consultant in Oral Surgery/ Honorary Senior Clinical Lecturer, Liverpool University Dental Hospital 14 BDJ Team www.nature.com/BDJTeam © 2021 British Dental Association. All rights reserved. FEATURE and CPD costs. In addition, the BADN have also lobbied 34 the GDC for a reduction in the annual 56 52 retention fee (ARF) for dental nurses to help Dental Practice ease fnancial pressures, or at least to allow for payment in monthly instalments. However, it Community Dental Service was confrmed at the GDC October Council meeting that the ARF is to be maintained at its current level for the coming year.6 Te BADN Hospital 888 President reports this refusal to recognise the dire fnancial plight of the largest registrant Other group, insisting on full payment of £114 by 31 July, has led to more than 3,500 dental nurses failing to re-register.5 Fig. 1 Responses to Q1: Where do you work? Materials and methods: A 24-point anonymous survey was created using Microsof Forms. Questions 1-22 are closed questions allowing for quantitative data 55 15 capture. Q23 – ‘If you have considered leaving Extremely confident dentistry altogether, please explain why’ and Q24 – ‘Do you have any other comments Confident 255 regarding the impact of COVID-19 on the 188 nursing profession?’ gave the opportunity for Neither confident or unconfident participants to express their concerns in their own words, providing qualitative data for Unconfident 493 analysis. Q23 and Q24 were then subject to thematic analysis to identify key trends. Extremely unconfident On 21 September 2020 a link to the online survey was shared on fve popular national dental nurses Facebook groups: Advice for Dental Nurses, Dental Nurse Support, Dental Fig. 2 Responses to Q8: To what extent are you confdent following new COVID-19 SOPs in your workplace? Nurse (UK), Support for Dental Nurses (UK), Northwest Dental Nurse Forum. Most Facebook groups are closed groups, ofen is it predominantly NHS or private? procedures are classed as AGPs? requiring full name and GDC registration Of the 86% (888 participants), 65% work in an Ninety-eight percent (985 participants) know number for the administration staf to grant NHS dental practice and 35% work in private what dental procedures are classed as AGPs. entry, although it is acknowledged there are practice. a number of members who are non-GDC Q7: To what extent has COVID-19 registered trainees. Permission to post the Q3: Have you worked in an Urgent changed your working practice? survey link to was granted by the group Dental Centre (UDC) during the Ninety percent (906 participants) report administrator on each occasion. Te link was COVID-19 pandemic? COVID-19 has signifcantly changed their posted by a registered dental nurse colleague at Eighty percent of respondents report they have working practice. Nine percent report COVID- Liverpool University Dental Hospital. not worked in an Urgent Dental Centre during 19 has slightly changed their working practice. the pandemic. Four participants reported their working Results practice has not changed at all. A total of 1,006 dental nurses completed the Q4: Have you been redeployed survey by 22 October 2020. One thousand and during the COVID-19 pandemic? Q8: To what extent are you confdent two of these responses were recorded between Ninety-three percent (931 participants) report following new COVID-19 Standard 21 September – 1 October 2020. that they have not been redeployed during Operating Procedures (SOPs) in your the pandemic; 7% (75 participants) have been workplace? Q1: Where do you work? Please tick redeployed. Te responses to Q8 are illustrated in Figure 2. all that apply. Twenty-fve percent (255 participants) feel Te responses to Q1 are illustrated in Figure 1. Q5: Are you undertaking Aerosol extremely confdent following new COVID-19 Eighty-six percent of participants work Generating Procedures (AGPs) at Standard Operating Procedures (SOPs); 49% in dental practice. Five percent work in the your place of work? (493 participants) feel confdent. Terefore, community dental service and 5% work in a Ninety-four percent of participants are a total of 74% feel confdent or extremely hospital. Tree percent work in ‘other’ which undertaking AGPs at their place of work; 6% confdent following new COVID-19 SOPs. includes: MOD, HMP, Locum, 111, EDS. (60 participants) are not undertaking AGPs. Only 1% feel extremely unconfdent and only 5% feel unconfdent. Nineteen percent feel Q2: If you work in a dental practice, Q6: Do you know what dental neither confdent nor unconfdent. www.nature.com/BDJTeam BDJ Team 15 © 2021 British Dental Association. All rights reserved. FEATURE Q9: To what extent do you feel safe following the new COVID-19 21 Standard Operating Procedures Very safe (SOPs) in your workplace? 78 Te responses to Q9 are illustrated in Figure 3. 196 Safe Nineteen percent (196 participants) feel very safe following new COVID-19 SOPs. 254 Neither safe nor unsafe Forty-fve percent (457 participants) feel safe. Terefore, 64% feel safe or very safe 457 following new COVID-19 SOPs. Eight percent Unsafe (78 participants) feel unsafe, and 2% (21 participants) feel very unsafe. Twenty-fve Very unsafe percent (254 participants) feel neither safe nor unsafe. Fig. 3 Responses to Q9: To what extent do you feel safe following the new COVID-19 SOPs in your workplace? Q10: I have received adequate training and support in implementing/undertaking these SOPs. 32 Te responses to Q10 are illustrated in Figure Strongly agree 4. Twenty-one percent (209 participants) 126 Agree 209 strongly agree that they have received adequate training and support implementing/ Neutral undertaking these SOPs. Tirty-seven percent 264 (375 participants) agree they have received 375 adequate training. Terefore, a total of 58% Disagree of participants agree or strongly agree they have received adequate training.